What is Chronic Kidney Disease?

Chronic kidney disease (CKD) is a progressive loss in kidney function over a period of months or years. Each of your kidneys has about a million tiny filters, called nephrons. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons that are left cannot filter your blood well enough to keep you healthy. When kidney function falls below a certain point, it is called kidney failure. Kidney failure affects your whole body, and can make you feel very ill. Untreated kidney failure can be life-threatening.

What you should not forget:

  • Silent: You can lose up to 90% of your kidney function before experiencing any symptoms.
  • Chronic kidney disease usually does not go away.
  • Kidney disease can be treated. The earlier you know you have it, the better your chances of receiving effective treatment.
  • Blood and urine tests are used to diagnose kidney disease.
  • Kidney disease can progress to kidney failure.

Treatable: If CKD is detected early and managed appropriately, the deterioration in kidney function can be slowed or even stopped, and the risk of associated cardiovascular complications can be reduced.

What you should not forget:

  • Keep fit and active
  • Keep regular control of your blood sugar level if you are diabetic.
  • Monitor your blood pressure
  • Eat healthily, reduce your salt intake and keep your weight in check
  • Stay hydrated (avoid dehydration)
  • Do not smokes
  • Do not take over-the-counter pills on a regular basis
  • Get your kidney function checked if you have one or

more of the ‘high risk’ factors:

  • you have diabetes
  • you have hypertension
  • you are obese
  • one of your parents or other family members suffers from kidney disease
  • you are of African, Hispanic, Asian, or Aboriginal origin.

Treating CKD

There is no cure for chronic kidney disease, although treatment can slow or halt the progression of the disease and can prevent other serious conditions developing. The main treatments are a proper diet and medications, and for those who reach the stage of kidney failure, long term dialysis treatment or kidney transplantation. In the early stages of kidney disease, a proper diet and medications may help to maintain the critical balances in the body that your kidneys would normally control. However, when you have kidney failure, wastes and fluids accumulate in your body and you need dialysis treatments to remove these wastes and excess fluid from your blood, dialysis can be done either by machine (hemodialysis)or by using fluid in your abdomen (peritoneal dialysis). In suitable patients a kidney transplant combined with medications and a healthy diet can restore normal kidney function. Dialysis and kidney transplantation are known as renal replacement therapies (RRT) because they attempt to “replace” the normal functioning of the kidneys and are discussed in more detail below.

Kidney Transplantation

A kidney transplant is an operation to place a healthy (donor) kidney in your body to perform the functions your own diseased kidneys can no longer perform.

Kidney transplantation is considered the best treatment for many people with severe CKD because quality of life and survival are often better than in people who use dialysis. However, there is a shortage of organs available for donation. Many people who are candidates for kidney transplantation are put on a transplant waiting list and require dialysis until an organ is available.

A kidney can come from a living relative, a living unrelated person, or from a person who has died (deceased or cadaver donor); only one kidney is required to survive. In general, organs from living donors function better and for longer periods of time than those from donors who are deceased.

Overall, transplant success rates are very good. Transplants from deceased donors have an 85 to 90% success rate for the first year. That means that after one year, 85 to 90 out of every 100 transplanted kidneys are still functioning. Live donor transplants have a 90 to 95% success rate. Long-term success is good for people of all ages.

WKD 2012 was devoted to spreading the message about the importance of organ donation and kidney transplantation for people with ESRD.

Dialysis

Healthy kidneys clean blood and remove extra fluid in the form of urine. They also make substances that keep our body healthy. Dialysis replaces the blood cleaning functions when kidneys no longer work.

There are two types of dialysis: hemodialysis and peritoneal dialysis.

In hemodialysis, your blood is pumped through a dialysis machine to remove waste products and excess fluids. You are connected to the dialysis machine through a needle in a vein that is surgically enlarged (vascular access) or through a temporary plastic catheter placed in a vein. This allows blood to be removed from the body, circulate through the dialysis machine for cleansing, and then return to the body. Hemodialysis can be done at a dialysis center or at home. When done in a center, it is generally done three times a week and takes between three and five hours per session. Home dialysis is generally done three to seven times per week and takes between three and ten hours per session (often while sleeping).

Peritoneal dialysis is another form of dialysis used to remove waste products and excess water. It works on the same principle as hemodialysis, but your blood is cleaned while still inside your body rather than in a machine by adding clean fluid to your abdomen, letting it accumulate waste products from the blood and then draining it out. It is typically done at home. Some patients can perform peritoneal dialysis continuously while going about normal daily activities (continuous ambulatory peritoneal dialysis, CAPD)